Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01531 | Date 05/10/2018 |
| Token No | SM/18-19/2510 05/10/2018 | Serial | 031 Last Visit: 22/01/2020 |
| Patient Name | Mrs. SUMI KHATUN | Contact No | 7890481284 |
| Address | CHATRA MUSALMAN PARA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||